Speak up to your doctor - it might just save your life

In a study that was mean to simulate what happens during a typical medical office visit, although the great majority of patients wanted to participate in their own medical care by giving their opinions about what should happen to them – what tests they should get, which procedures to get, etc – and although more than 90 % felt they could ask their doctor anything and could discuss the various options open to them in an easy manner with their physician, the vast majority of those patients were nonetheless reluctant to tell their doctor that they disagreed with a decision the doctor had made on their behalf.

And that’s just not right.

Medicine is an imperfect discipline in which there are often many seemingly similar – maybe even equal – choices that can be made and there is rarely a “best” answer, just a whole lot of equally OK answers.

Not only that but often, a great deal of an outcome depends on the patient – what they feel comfortable with, what makes them cringe and reluctant to go on, etc.

So if something doesn’t feel right, always feel free to tell your doctor – chances are, he/she will readily change their mind about what you should do based on what you tell them you’d prefer. 

Big babies boost breast cancer odds

In a recent study published in the journal, PLoS One, women who had delivered big babies, which in this study meant babies bigger than 8 ¼ pounds (not that big, really), had a higher risk of breast cancer than women who delivered smaller babies.

And this was not a small, hardly noticeable risk but rather the risk was up to 2 ½ times higher, making this factor – the delivery of a big baby – an important indicator for breast cancer screening.

In fact, it would be a good idea for women who have delivered such big babies to do the other things we know that might reduce their risk of breast cancer, namely participating in regular exercise and watching their overall alcohol intake.

And at the very least women who have delivered these larger babies should stay on top of their breast cancer screening with regular mammograms.

A bun fight among doctors

But it’s not a fun bun fight.

Rather, it’s about the very serious matter of when to start testing kids for cholesterol abnormalities.

The fight began when a few months back, an expert panel recommended much more widespread screening of kids – even as young as infants – for cholesterol abnormalities because of the view of panel members that the sooner a cholesterol-related problem is treated, the better the long-term outcome.

The problem with this advice, which sounds so benign, is that in this medication-enraptured world, you can bet that a large number of kids with even mid cholesterol abnormalities will quickly be put on statin drugs to try to improve those abnormal levels, even though the panel insisted that few kids actually need drugs (most would respond to the obvious lifestyle adjustments of more exercise, better diet, and weigh control).

And the kids will be on those drugs for life, probably.

Further, there is really no proof that long-term use of drugs in kids will make any difference to most of them nor that these drugs are even safe: they have just not been studied enough in kids.

So happily, an editorial in the prestigious journal, Pediatrics, has come out very strongly with just such criticism of the panel’s recommendations, a view that mirrors my own.

This panel’s advice is ridiculous.

What every kid – and every kid’s caregivers – need to do is follow those simple lifestyle health habits.

And then, when a kid reaches early adulthood, if his situation warrants it, only then should he or she consider getting tested. 

YouTube can help you

A common and very frustrating problem that seems to affect far too many aging boomers is something called benign positional vertigo, a condition which comes on suddenly and leads to a sensation that everything around you is spinning (that’s vertigo).

BPV is due to crystals that suddenly move into the organs of balance in the inner ear.

Think of this as ear junk that like the young boys in Fagin’s employ, changes lodgings.

But the great thing is that these crystals can be easily dislodged again with a maneuver known as the Epley maneuver, which offers immediate and very welcome relief, and there are dozens of videos on YouTube showing how to do that maneuver.

So it’s nice to learn that a review of these videos by an unbiased reviewer found that they’re very accurate and quite helpful for most people.

Now vertigo can clearly be due to lots of other reasons besides changing position so if the symptoms persist, it’s quite important to rule out more serious conditions.

But as a first approach for most people with sudden onset vertigo, it’s worth a quick view of a relevant video and an attempt to do that maneuver.

Vitamin D for heart disease? Not so fast

I wish I had vitamin D’s publicist working for me cuz I would have retired years and years ago from all the misplaced hype I would have garnered.

Thus, unless you’ve been living in a cave, and most likely even if you have, you would surely know by now that these days vitamin D is being promoted for everything from lowering the risk of terrible diseases such as cancer to improving your ability to play the piano.

Well, to be fair, no one seems to have made the latter claim yet but I’ll bet someone is working on a study that proves exactly that.

Anyway, among the many claims made for vitamin D is that higher vitamin D levels could significantly lower the risk of various forms of heart disease, claims that are made on the basis of many studies that have found that people with lower vitamin D levels seem to have higher rates of many heart problems, including worse cholesterol profiles.

The problem such studies, however, is pretty simple to a simple person like me: seems to me that the main reasons that most people with lower vitamin D levels would have such low levels because they 1) don’t go into the sun as much as people with more normal vitamin D levels, hence they are less likely to exercise outdoors or even to just walk and relax in a park, and 2) they have poorer diets.

So simply upping the vitamin D levels in people with low levels through the use of supplements has always seemed to me to be a poor way to improve these people’s health status, and I’ve always been skeptical of the ability of vitamin D supplements to make any difference in health outcome for most people.

Which is why I wasn’t at all surprised that a study that reviewed 4 million – that’s 4 million – health records concluded that in people with low vitamin D levels and with concurrent abnormal cholesterol levels, raising their vitamin D levels with supplements – which was documented through blood tests that showed that their vitamin D levels had indeed risen to normal levels – had no effect at all on their cholesterol levels.

You wanna take vitamin D to help with your bones?

Fine, makes some sense.

You wanna take vitamin D to lower your heart attack risk?

Still makes no sense to me.